MOST

Cheryl and I went to a care planning meeting about Rick at the nursing home this morning. It was mainly to complete the advanced care directive called MOST (Medical Orders for Scope of Treatment). It is just a more detailed ‘Do Not Resuscitate’ form. The following are the directives we chose.

• ·       Comfort Measures” Keep clean, warm and dry. Use medication by any rout, positioning, wound care and other measures to relieve pain and suffering. Use oxygen, suction and manual treatment of airway obstruction as needed for comfort. Do not transfer to hospital unless comfort needs cannot be met in current location.
• ·       Determine use or limitation of antibiotics when infection occurs.
• ·       IV fluids for a defined trial period
• ·       No feeding tube

They said that his disease is progressing and each time he gets sick, like with pneumonia, he more than likely will not return to his pre-sick condition. Just like with his last bout of pneumonia. They said that it is not ‘if’ he gets pneumonia again, it is ‘when’.

They did a swallow test this morning at High Point Regional Hospital. It showed that he is having ‘silent aspiration’ when he drinks thin liquids. They recommend he be on nectar thick liquids, pureed meats and mechanically soft sides. If we want to give him regular foods, we have to sign a form saying that we know the recommendations and are refusing to cooperate and adhere to the diet and take responsibility for any adverse affects that might happen.

Then they recommended he be referred to Hospice. I asked if they thought he was ready for that now and, without hesitation, they said yes. So we will be hearing from Hospice shortly to get him enrolled. 

I just got a call from United Hospice and our initial visit is Thursday morning, July 12.